Anderson



March 25, 1952 R. ANDERSON 2,590,670

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a Roger nderson n BY WWW' Ef AT1-ORNE s March 25, 1952 R. ANDERSON 2,590,670 INTERSCPULAR PATIENT SUPPORTING DEVICE FOR APPLICATION oF AN ORTHOPEDIC BRACE Filed July 26, 1949 2 SHEETS-SHEET 2 mms/Tok. Roger Hna/arson BY il ATTORNEYS Patented Mar. 25, 1952 UNITED STATES PATENT OFFICE I INTERSCAPULAR PATIENT SUPPORTING DEVICE FOR APPLICATION OF AN ORTHOPEDIC BRACE Roger Anderson, Seattle, Wash. Application July 26, 1949, Serial No. 106,954

2 Claims. (Cl. 128-71) My invention relates to an inter-scapulai' patient supporting device for application of an orthopedic brace. More particularly, my invention relates to a relatively small, plate-like, detachable support which may be aligned with the spinal column of a patient at the shoulder blade level and which will support the patient between the scapulae for application about the patient and about said supporting means of an orthopedic brace, which orthopedic brace includes a jacket cast. Also my invention includes such a support about which an orthopedic cast may be formed and which support can be subsequently removed from within the cast. It is now standard technique to provide orthopedic braces or casts embodying either` plaster-of-Paris or synthetic materials, the later following the teachings of my Letters Patent Number 2,489,252.

My invention is a continuation, in part, of my copending application entitled Orthopedic Table and Fracture Reducing Apparatus, Patent No. 2,477,562, led October 17, 1945, issued August 2, 1949 (hereinafter referred to as my orthopedic table patent) While my present invention may be used in connection with other orthopedic tables than that illustrated in my said orthopedic table patent, for purposes of illustration and to better understand the present invention, the same, by way of example and not by Way of limitation. will be explained and illustrated in connection with the orthopedic table oi said patent and without unnecessary detailed consideration of the said orthopedic table.

A jacket cast as used herein includes casts which are formed about the trunk of a patient and which may extend to include the head of the patient, or may extend to include the patient's legs or arms. In the prior art of applying jacket casts, one procedure was to place the patient in a sitting or standing position and to exert upward pressure on the neck of the patient. Then a cast was applied about the trunk of the patient while the patient was in this position. Diiiiculties involved in this technic include: the patient must be in such physical shape and not anesthetized so that the patient can cooperate during the application of the cast; such technic requires several trained assistants as well as the surgeon in charge of the operation; any angular corrections of the neck or of the spinal column of the patient are exceedingly diflicult to obtain and more difcult to maintain during the application of the j cast; and resultant shock or extreme discomfort to fthe patient which usually obtains because of such 2 technic, as the patient, in substance, is suspended by the neck.

Another prior art practice employed in applying jacket casts was to span two spaced apart tables with the body of a patient and with the patients arms resting on one table and with the lower limbs resting on the other table. Substantially the same difficulties obtained in this technic as'were involved in the above mentioned technic.

Another technic involved the use of a rather narrow and supported board or slat on which the patient was lplaced in a supine position, and which slat supported the spine substantially throughout its length. In other words, the patient was on his back on the supported slat, facing upwardly, and the slat extended substantially from the head of the patient to the buttocks. Generally such slats extended beyond both the head and the buttocks so the sla-t could be supported at each end. Thereafter a cast was wrapped about the narrow slat and the patient, and the slat was removed later. While many of the diiculties above mentioned Were involved in this technic, characteristic difficulties of this technic involved the groove-like ridge left in the back of the cast which was disposed directly adjacent the backbone area of the patient and obviously led to great discomfort during the time when the patient was required to wear the cast. An even greater characteristic dilculty inherent to this technic involved the fact that the slat wasnonconforming to the contour of the spinal column and hence desired corrective shaped casts could not .be made in this manner. When slats were employed in this technic, the slat was generally extended so as to support the head of the patient. With a slat in such position, obviously it was substantially impossible to provide, in connection with a jacket cast, a head cast of desired t and particularly so if it were desired to urge the chin upwardly and arch the back of a patients neck.

The above mentioned, and many other, difficulties are overcome by devices embodying my invention as the patient, with my invention, may be supported at the buttocks and at the head and with only a relatively small inter-scapular button of my invention disposed between the said two supports, which inter-scapular button is disposed between the scapulae of the patient and aligned with the spinal column of the patient.

The above mentioned general objects of my invention, together with others inherent in the same, are attained by the devices illustrated in be highernien the other, and sufneient movenient is provided to accomplish such purpose by reason of the crosspin 56 movable in a general horizontal direction in the slot 51. The shafts 54 and55 extend downwardly through carriage housings 58 and 59, respectively. Carriage housings 58 and 59 are supported and preferably releasably locked to tubular members 42 and 4I. The trunk of a patient is supported in accordance with the present invention by an interscapular support or rest 66, which may be supported by a tubular member 6l carried Iby bracketr 22., A threaded shaft 62 telescopically and threadedly inteiits with tubular rnember'l and relative angular movement between seid tubuier member 6l vand shaft 62 vispreyented as by pin means 63 carried byshaft 62, which pinr'ne'ans 63 inter'ts with longitudinal "slot 64 tubular member sl. Nut ineens 65 is threaded en shaft 62 and thus upon angular mvement in one direction urges shaft 62 and inter-scapular support 60 upwardly and upon movement in the other direction permits the same to descend and urges the support 60 off of tubular number 62 (see Fig. 3). The said inter-scapulai support and variations thereof, as Well as the mode of operation thereof, will be hereinafter more fully explained. v

,Vary often when the inter-scapular support 69 is employed, it is desirable to support the occiput or the back ofthe head of a patient and with limited restricting apparatus adjacent the head of a patient and adjacent Vthe scapulae of a patient so as to eliminate any obstructions in-y terfering with the applying of a cast. preferably provide a tubular member 66 carried by bracket 22 and more particularly in hole 30 of said bracket.

isv provided with ea pin 63 slideable thereinto prevent relative movement between tubular member 66 and shaft 68 as was described in connection with shaft 62 and tubular member 6I. Obviously, shafts having squared or other patterned portions and mating patterns in the tubular members may be employed in lieu of the pin and slot means described in connection with tubular member 6l and shaft 62. The shaft 68 supports an L-shaped bracket 69 which, in turn, supports a cup-shaped head rest 10, and the said head rest 10 is preferably detachably connected with said L-shaped bracket 69, as is more particularly described in my co-pending application directed `toward the same, Serial No. 106,953 led July 26, 1949.

An extension member 1| is suitably connected with the bracket member 22 as by bolt and nut means 12 operating in opening 34 in bracket 22, and stud 13 operating in opening 33 in said bracket 22. Extension member 1I carries 'an upright post 14, which upright post carries threaded shaft and nut means 15. The threaded shaft andt'nut means 15 are mounted on vpost 14 preferably so the shaft will not rotate but can be moved horizontally by rotary movement of the nut means. The inner end of the threaded shaft carries a hook member 16 which, -in turn, may be ennected to 'a -headsling 11.

By reason of the keyway 31 associated with hole V(Fig. 2) and a, key or pinv tenero In, thenevent that tensionf is placed on the head f the patient through head sling 11, the cunteretraction may be placed on the feet of the patient by structure illustrated in my Patent No. 2,469,361, which is also illustrated in my said orthopedic table patent. Generally, said means comprise a threaded shaft 18, and a nut means 19 which are supported for longitudinal movement. by the bracket 50 so that the threaded shaft 18 may movelongitudinally but will not turn relative to the bracket 56. The inner end of the threaded shaft 18 supports a bracket 8|! which, turn, supports a foot plate 8l. Strap means 82 are patient and thus connect each foot of a patient izda` foot plate 8|.

, In the foregoing description the various parts here illustrated and described have been illuss'ttra'ted and described more fully in my said orthopedic table patent,` of which the present application is a continuationein-part, and hence many of the details which show one operative environment of the present invention have not been fully described and illustrated in detail in the interest of brevity.

In general it may be stated that a patientcan be supported at the buttocks on sacral rest 83 and maintained there -by the leg boards, or foot plates, jetc. Next the head may be supported by the head rest 10 and parts associated therewith. The only support between such two supports is my inter-scapular support 6D.

Referring now to Figs. 3 and 4 of the drawings, one form of the present invention is there illustrated and shown more completely in detail. After' the mid-portion of a patient has been supported by the inter-scapular support 60 and the retrieving strap 86 has been aligned so that the free end thereof will protrude from the cast, a cast 84, indicated by the dot and dash lines in Figs. 1 and 3, may be applied about a patient and also about the inter-scapular support 60 as well as the retrieving strap 86. The inter-scapular support 66 is provided with holes 85 which are longitudinally aligned as respects the interscapular support 66 and the retrieving strap 86 connected with said support 60. Each of these holes 85 interts with a reduced end portion 81 of shaft 62. In other words, if longitudinal adjustment is desired between the inter-scapular support 68 and the cup-shaped head rest 10, this may be accomplished by selecting the desired hole of the series of holes numbered 85.

After the vcast 84 has sufciently set or hardenedso it is possible or desirable to move the patient, then the nut means and 61 may be angularly moved in the appropriate direction and the shafts 62 and 68 will move downwardly until downward movement of the cast 84 and parts thereabove is arrested by contact with the nut 65. Further movement of nut 65 thereafter functions to move the shaft 62 and the reduced end portion 81 downwardly until said reduced end portion is positively removed from an opening in the support 6U. By releasing any other fastening means which may secure the patient 'onthe table, such as foot strap means 82 and head sling 11, then the patient can be removed from the table. It will be noted that the button 60 as well as the retrieving strap 85 is left between the cast 84 and the patient. Subsequently, the 'support 6l) may be removed by pulling on the free end of the retrieving strap 66 which has been left out of the cast 84. Normally a wellet'ted Jacket cast is 'suliiciently -l'oos'e from a patient wrapped aboutach foot of'a mally patient, my invention also contemplates having gIn Figs. 5 and 6 of so that -if the cast is placed on the patient when vthe patient is in a supine position, then the support 60 can be readily removed if the patient is turned to a prone position. While in some instances We will have nurses with sufficiently small hands or we may have suiciently short jacket casts so that the supporting member 60 formed by shaft 62. The shaft 62 which carries the inter-scapular support 60 under normal circumstances can be moved from under the interscapular support 60 so that the inter-scapular support 60 mitted to rest on a fixed support by lowering the adjustable support Which comprises shaft 62.

and the patient thereon can be per- Instead of having the movable support 62 norcarry the inter-scapular support and the afixed support which normally carries the interscapular support as Well as the patient and a movable rest which will lift the inter-scapular support and the patient off of the xed support. Such a construction is illustrated in Figs. and

6 of the drawings. Fig. 5 shows parts illustrated in the preceding figures and which parts are inthe drawings provides 53, head on head rest lill.

corporated by reference to the numbers appearing on the parts and they include: frame tubes 2|, bracket member 22, gear box 25, crank 26, tubes 38, tube 39, vertically adjustable table 23, nut and bolt means 12, tubular member 65, nut member 61, post 14, threaded shaft and nut means 15, hook 16, head sling 11 and cast 84. The bracket member 22 in Figs. 5 and 6 may be the same as bracket member 22 as shown in Fig.' 2 of the drawings except holes 28, 29 and 30 are through holes so that tubes 38 and 39 may have the movement illustrated in Figs. 5 and 6 of the drawings. Means to urgethe table 23 upwardly and permit the same to descend may comprise tubular member 88, threaded shaft 89, and nut means 98. Relative angular movement between f the threaded shaft 89 and tubular member 88 is prevented in a manner similar to that illustrated in connection with the other elevating devices mentioned herein. Thus by manipulation of the nut means 90, table 23 may be moved to the position illustrated in Fig. 5 of the drawings where the same does not support the patient or Ato the position shown in Fig. 6 of the drawings where the patient is supported by the table.

In place of the means for supporting the interscapular support involving parts 6|, 62 land of the previous figures, I may also use two spaced apart posts 9| which 'have end portions interiitting openings 36 in the bracket member 22 and which pass through and permit table-23 to slide therepast. The other end portions of the posts 9| interfit in openings 92 in the interscapular support 60 (see Fig. 4). I have not illustrated longitudinal adjustment of the interscapular support 68 when supported on posts 9| relative to a head rest supported through tubular member 66, but this may be done as desired by having a plurality of longitudinal spaced sets of openings 82 similar to the longitudinally spaced openings 85.

the drawings, I have shown a. modified form of head rest wherein the head rest is still supported by a tubular member 66 from the bracket member 22. The parts so illustrated in Figs. 5 and 6 of the drawings comprise threaded shaft 93, connector 94, which is mounted for angular movement on shaft 93 and any adjusted position can be maintained by reason of screw 95 having a suitable and readily engageable wing nut thereon. An opening is provided in the connector 94 to slidably receive shaft 96. Screw 91 with a suitable wing nut head thereon adjusts any desired relative position between the connector 94 and the shaft 96. One end portion of the shaft 96 is provided with a projecting pin 98, which pin 98 mounts bracket 99 for relative angular movement thereon. A set screw |00 with a suitable wing nut thereon is provided to maintain an adjusted position. Thus desired angular position between shaft 96 and the bracket 99 may be provided, and then by tightening of screw |00 such adjustment may be maintained. The bracket 99 carries a cup shaped head rest lill which is similar in function to the cup head rest 10.

First the parts are moved to a position with table 23 up so va patient can be readily placed with the buttocks on sacral rest 83, legs on boards Also the sling 11 and foot plates 8| may be used when desired. Then the parts are moved to the relative positions shown in Fig. 5 of the drawings so that the portion of the patient between the buttocks and the head is supported by the inter-scapular button 60. At this time the table 23 is in its down position as shown in Fig. 5 and then a cast 84 is applied about a patient and about the inter-scapular support 69. When it is desired to move the patient from the orthopedic table, the adjustable table 23 is moved upwardly, and when the table 23 contacts the cast 64 aligned with th-e interscapular button 60, then further upward movement of the adjustable table 23 thereafter moves the cast 84, the inter-scapular button 60, and the patient upwardly. This, of course, removes the inter-scapular button G0 from the posts 9|. After the patient has been released from any fastening means involved, then the patient can be removed from the table proper to any desired location and at an appropriate time after removal of the inter-scapular button 60 from the posts 9|, the inter-scapular button 60 may be removed from out of the cast as has been previously indicated in connection with said interscapular button.

From the foregoing it will now be apparent that I have provided a supporting member for an inter-scapular support, which supporting member may include the posts 9| or the threaded shaft 62. Either of said supports presents a re1- atively small cross-sectional area at its upper y portion, and thus a cast can be wrapped around such support and the support can be moved out of the cast without large openings of a size which will in any wise substantially materially weaken the cast. Furthermore, such supporting means detachably support a relatively thin detachable support which presents a relatively large interscapular support for a patient which is embodied in inter-scapular support 69.

It is further apparent that by relative motion between the supports 9| or 62 and the inter-scapular button 60,

I am able to remove the supports from the interscapular support and leave the inter-scapular support within the cast and to then later remove the inter-scapular support 69 from within the cast, as desired. Also I may support a patient on a relatively fixed support 9| and move the interscapular support 60 away from the same as by moving table 23, or I may support the patient on a relatively movable support such as shaft 62 and move the support 62 downwardly until a xed support such as nut means 65 removes the interscapular support 60 from the shaft E2.

Obviously changes may be made in the forms, dimensions and arrangements of the parts of my invention without departing from the principle thereof, the above setting forth only preferred forms of embodiment of my invention.

I claim:

1. A device for supporting' a Ipatient for application of an orthopedic cast comprising a vertically disposed supporting shaft; a relatively thin, fiat, inter-scapular plate detachably connected with said supporting shaft for alinement with the spinal column of a patient at the shoulder blade level and between the shoulder blades; and a. exible retrieving member secured to said detachable inter-scapular plate and of a length to extend out of the cast, whereby an orthopedic cast may be applied to a patient about said detachable inter-scapular plate and said flexible retrieving means, relative motion may be applied between said detachable inter-scapular plate and said vertical shaft, and said detachable interscapular plate may be subsequently removed from within the orthopedic cast by a pull exerted plaster cast be applied about the chest of a patient comprising a pelvic area supporting means for supporting the Ipelvis `of a patient at the back side of the patient; a head support for supporting the back side of the head of a patient; and an intermediate support disposed between the said two mentioned supports and adapted to support the patient at the spinal column and between the shoulder blades consisting of a relatively thin, at, inter-scapular supporting plate and supporting means therefor', and said -plate being readily removable from its supporting means.

ROGER ANDERSON.

REFERENCES CITED The following references are of record in the le of this patent:

UNITED STATES PATENTS Number Name Date 1,470,362 Hawley Oct. 9, 1923 2,306,929 Bergamini Dec. 29, 1942 FOREIGN PATENTS Number Country Date 435,995 Great Britain Sept. 24, 1935 March 25, 1952 A. w. BAKER EXPLOSIVE CARTRIDGE ASSEMBLY 2 SHEETS- SHEET l Filed June 19. 1948 INVENTOR: m22.u aff/34W;

HIS ATTORNEYS. 

